Abstract. Schistosomiasis is a parasitic worm infection that affects over 260 million individuals worldwide. Women with schistosome infections have been demonstrated to have a 4-fold increase in the odds of human immunodeficiency virus (HIV) infection compared with women without schistosome infections. A relationship between schistosome and HIV infections has not been clearly defined in men. Among 674 men aged 18-50 years living in rural Tanzania, we identified 429 (63.6%) who had a schistosome infection as defined by serum positivity for schistosome circulating anodic antigen, visualization of parasite eggs in urine or stool, or both. HIV infection was identified in 38 (5.6%). The odds of HIV infection was 1.3 [95% confidence interval = 0.6-2.5] (P = 0.53) among men with any schistosome infection (Schistosoma haematobium or Schistosoma mansoni), and it was 1.4 [0.6-3.3] (P = 0.43) among men with S. haematobium infection. Men with S. haematobium infection were significantly more likely to report the symptom of hemospermia than men without S. haematobium infection. We conclude that schistosome infections appear to have little to no association with HIV infection in men.

Background: Body composition is an important indicator of nutritional status and health. How body composition changes during 12 mo of breastfeeding in HIV-infected women receiving antiretroviral therapy (ART) is unknown. Objective: We assessed whether HIV or food insecurity was associated with adverse postpartum body-composition changes in Ugandan women. Design: A cohort of 246 women [36.5% of whom were HIV positive (HIV+) and were receiving ART] were followed to 12 mo postpartum. Repeated measures included weight, fat mass, fat-free mass, midupper arm circumference, triceps skinfold thickness [which allowed for the derivation of arm muscle area (AMA) and arm fat area (AFA)], breastfeeding, and individual food insecurity. Longitudinal regression models were constructed to assess associations between HIV and food insecurity and changes in body composition over time. Results: At baseline, HIV+ women compared with HIV-negative women had a higher mean 6 SD food-insecurity score (11.3 6 5.5 compared with 8.6 6 5.5, respectively; P , 0.001) and lower AMA (40.6 6 5.7 compared with 42.9 6 6.9 cm 3 , respectively; P = 0.03). Participants were thin at 1 wk postpartum [body mass index (BMI; in kg/m 2 ): 22.9 6 2.9]. From 1 wk to 12 mo, the weight change was 21.4 6 4.4 kg. In longitudinal models of body-composition outcomes, HIV was not associated with body composition (all P . 0.05), whereas food insecurity was inversely associated with body weight and BMI at 6, 9, and 12 mo and with AFA at 6 and 12 mo (all P , 0.05). At 6 mo, every 1-unit increase in the food-insecurity score was associated with a 0.13-kg lower body weight (P , 0.001) and a 0.26-cm 3 lower AFA (P , 0.01).Conclusions: Body-composition changes are minimal during lactation. HIV is not associated with body composition; however, food insecurity is associated with changes in body composition during lactation. This trial was registered at clinicaltrials. gov as NCT02922829 and NCT02925429. Am J Clin Nutr 2017;105:361-8.

Antenatal alcohol use (AAU) is associated with poor health outcomes in maternal‐infant dyads. However, AAU prevalence and risk factors are poorly understood, particularly in low‐income settings. Therefore we studied correlates of any AAU among pregnant women receiving antenatal care in Gulu, Uganda.Characteristics of pregnant women enrolled in a cohort study (n=403, 33% HIV+) were assessed at multiple levels of the social‐ecological model (SEM).AAU was reported by 20.1% of participants. Beer (10.1%) and kweete (sorgum‐millet brew) (9.2%) were the most frequently consumed alcohols (Figure 1). Excessive drinking was rare; mean alcohol units consumed/month was 4.4 in those who drank.In multivariate logistic models, social environment, (partner drinking 蠅30 days/month, [Odds Ratio (OR) 2.17, p=0.03] or friends drinking 1‐29 days/month [OR 3.59, p<0.001]), maternal age [OR 1.06, p value=0.01], and greater food security [OR 0.93, p=0.02} were associated with AAU (Table 1). Many covariates of AAU seen elsewhere in sub‐Saharan Africa, including HIV, maternal depression, and domestic violence were not significant.Future research may focus on peer and partner‐based interventions and behavior change at multiple levels of SEM to reduce AAU.Funding: USAID Feed the Future Innovation Laboratory for Collaborative Research in Nutrition for Africa (AID‐OAA‐L‐10‐00006 to Tufts University). SLY was supported by NIH (K01 MH098902). Table 1. Bivariate and multivariate logistic models of any alcohol use during pregnancy among 403 pregnant Ugandans of mixed HIV status Characteristic Unadjusted OR p‐value Adjusted OR p‐value Maternal Characteristics Maternal Age (y) 1.05 (1.00‐1.10) 0.01 1.06 (1.01‐1.12) 0.01 HIV‐positive 0.68 (0.39‐1.18) 0.17 0.60 (0.32‐1.12) 0.11 Depression score1 1.00 (0.98‐1.02) 0.70 Maternal education level ≥Primary Secondary &gt;Secondary ref 1.04 (0.61‐1.78) 2.26 (1.01‐5.03) 0.17 0.04 ref 1.05 (0.58‐1.90) 1.03 (0.39‐2.68) 0.86 0.94 Maternal Nutrition Food insecurity score2 0.95(0.91‐1.00) 0.05 0.93 (0.88‐0.99) 0.02 Dietary diversity score3 1.17 (1.02‐1.35) 0.02 Household and Interpersonal Characteristics Partner drinks (days/month) Never 1‐29 ≥30 ref 1.43 (0.79‐2.56) 1.87 (1.00‐3.50) 0.04 0.22 ref 1.05(0.55‐1.99) 2.17(1.06‐4.44) 0.86 0.03 Friends drink (days/month) Never 1‐29 ≥30 ref 2.99 (1.65‐5.42) 2.00 (0.74‐5.36) &lt;0.001 0.16 ref 3.59 (1.84‐7.00) 1.78 (0.60‐5.26) &lt;0.001 0.29 Domestic violence4 1.53 (0.90‐2.59) 0.11 1.63 (0.91‐2.90) 0.09 Asset score5 1.13 (1.01‐1.27) 0.02 1.06 (0.93‐1.22) 0.34 Community and Environmental Characteristics Urban residence 0.88 (0.48‐1.60) 0.67 Displaced during civil war 1.36 (0.76‐2.43) 0.29 Lived in an internally displaced persons camp 0.95(0.58‐1.55) 0.84 Years displaced to IDP camp None 1‐4 5‐10 &gt;10 ref 0.90 (0.18‐4.57) 1.00 (0.18‐5.28) 1.00 (0.20‐4.91) 0.90 1.00 0.99 1Depression score (0‐56) Center for Epidemiologic Studies Depression Scale (CES‐D) 2Individually‐Focused Food Insecurity Access Scale (IFIAS); Natamba et al., 2014 3Dietary diversity (0‐26), FAO HDDS Scale; FAO 2011 4Domestic violence: sexual and physical violence within the past year 5Asset score (0‐12) based on possession of 12 household items of value [figure1]

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